Published Studies Related to Ephedrine Injection
The effect of combined ephedrine and lidocaine pretreatment on pain and hemodynamic changes due to propofol injection. [2011.06]
OBJECTIVES: Injection pain and hypotension are two main adverse effects of propofol that discourage uniform acceptation. The aim of this study was to compare the effect of ephedrine-lidocaine combination with lidocaine and ephedrine alone on injection pain and hemodynamic changes caused by propofol injection... CONCLUSION: Pretreatment with combination of small-dose ephedrine and lidocaine could reduce the incidence and intensity of propofol-induced pain and also result in more stable hemodynamic profile, but however, the combination of two drugs failed to work better in further reduction of pain. Copyright (c) 2011. Published by Elsevier B.V.
[Prophylaxis for hypotension during cesarean section under spinal anesthesia: a randomized trial comparing hydroxyethyl starch 130/0.4 to ephedrine]. [2011.01]
BACKGROUND AND OBJECTIVE: Spinal anesthesia is the technique of choice for scheduled or emergency cesarean section, but the prevalence of hypotension is high in this setting. Our aim was to compare the efficacy of a colloid (6% hydroxyethyl starch [HES] 130/0.4) to ephedrine for preventing hypotension... CONCLUSIONS: HES 130/0.4 is as useful for hypotension prophylaxis as 5-mg or 10-mg intravenous doses of ephedrine. HES 130/0.4 might be a substitute for sympathomimetic agents if adverse effects are predicted or contraindications to the use of such drugs are present.
Comparison of intravenous ephedrine with phenylephrine for the maintenance of arterial blood pressure during elective caesarean section under spinal anaesthesia. [2010.03]
Hypotension is a major concern of the anaesthetists whenever subarachnoid block is performed especially in obstetric patients. Vasopressors have been shown to be more effective at limiting spinal hypotension than other treatment of hypotension like preloading and left uterine displacement...
The effects of intravenous ephedrine during spinal anesthesia for cesarean delivery: a randomized controlled trial. [2009.10]
We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21)...
Admixture of ephedrine to offset side effects of propofol: a randomized, controlled trial. [2009.02]
STUDY OBJECTIVE: To determine whether adding ephedrine to propofol is as effective as adding lidocaine at reducing injection pain, and its effects on hemodynamics... CONCLUSION: Adding 30 mg of ephedrine to 20 mL of 1% propofol is as effective as adding lidocaine in preventing injection pain, and it results in a more stable hemodynamic profile.
Clinical Trials Related to Ephedrine Injection
The Effect of Combined Ephedrine and Lidocaine Pretreatment on Pain and Hemodynamic Changes Due to Propofol Injection [Recruiting]
Objectives: Injection pain and hypotension are two main adverse effects of propofol which
distresses patient. The aim of this prospective double blind study was to compare the effect
of ephedrine - lidocaine combination with lidocaine and ephedrine on injection pain and
hemodynamic changes due to propofol induction.
Methods: 165 adult patients, aged 20 to 60 yr, Patients were randomly allocated to one of 5
groups (33 patients per group): lidocaine 0. 5 mg/kg(L) ,ephedrine 30microgram/kg (E30),
ephedrine 70 microgram/kg(E70), lidocaine 0. 5mg/kg - ephedrine 30 microgram/kg(LE) or 2ml
saline (S) intravenously. After one minute propofol 2 mg/kg into a dorsal hand vein was
injected. Face pain scale and verbal rating scale, arterial blood pressure and heart rate
were recorded before induction, just before intubation, and one minute after intubation
Phenylephrine in Spinal Anesthesia in Preeclamptic Patients [Recruiting]
Hypotension remains a common clinical problem after induction of spinal anesthesia for
cesarean delivery. Maternal hypotension has been associated with considerable morbidity
(maternal nausea and vomiting and fetal/neonatal acidemia). Traditionally, ephedrine has
been the vasopressor of choice because of concerns about phenylephrine's potential adverse
effect on uterine blood flow. This practice was based on animal studies which showed that
ephedrine maintained cardiac output and uterine blood flow, while direct acting
vasoconstrictors, e. g., phenylephrine, decreased uteroplacental perfusion. However, several
recent studies have demonstrated that phenylephrine has similar efficacy to ephedrine for
preventing and treating hypotension and may be associated with a lower incidence of fetal
acidosis. All of these studies have been performed in healthy patients undergoing elective
Preeclampsia complicates 5-6% of all pregnancies and is a significant contributor to
maternal and fetal morbidity and mortality. Many preeclamptic patients require cesarean
delivery of the infant. These patients often have uteroplacental insufficiency. Given the
potential for significant hypotension after spinal anesthesia and its effect on an already
compromised fetus, prevention of (relative) hypotension in preeclamptic patients is
important. Spinal anesthesia in preeclamptic patients has been shown to have no adverse
neonatal outcomes as compared to epidural anesthesia when hypotension is treated adequately.
Due to problems related to management of the difficult airway and coagulopathy, both of
which are more common in preeclamptic women, spinal anesthesia may be the preferred regional
anesthesia technique. Recent studies have demonstrated that preeclamptic patients may
experience less hypotension after spinal anesthesia than their healthy counterparts. To our
knowledge, phenylephrine for the treatment of spinal anesthesia-induced hypotension has not
been studied in women with preeclampsia. The aim of our study is to compare intravenous
infusion regimens of phenylephrine versus ephedrine for the treatment of spinal anesthesia
induced hypotension in preeclamptic patients undergoing cesarean delivery. The primary
outcome variable is umbilical artery pH.
Ephedrine vs Phenylephrine - ECG Changes [Not yet recruiting]
ECG changes during caesarean section are common. Incidence of ST depression on the ECG is up
to 81% in some studies. Although this may indicate inadequate oxygen supply to the heart
muscle (myocardial ischaemia) many other theories have been suggested including air entering
the circulation from the placental bed, high heart rate, hormone or nervous system
influences and spasm of the coronary blood supply. Perioperative ST depression often
reflects an imbalance between heart muscle oxygen supply and demand. At the time of
delivery, high heart rate is common and there is a further increase in the amount of blood
the heart has to pump every minute due to blood coming back to the circulation from the
placental bed. This increases oxygen demand and most ST changes are seen at the time of
delivery or within 30 minutes. The clinical significance of these changes is much debated,
and apart from a few case reports do not appear to be associated with poor heart muscle
function or ischaemia (lack of oxygen supply). Management of the mother's blood pressure
during caesarean section has changed greatly in recent years. Intermittent boluses of
ephedrine, given when blood pressure is low, have been replaced with prevention of low blood
pressure and phenylephrine has become the drug of choice. Ephedrine increases heart rate and
contractility of the heart muscle and is likely to increase oxygen demand. Phenylephrine
reduces heart rate while maintaining blood pressure which may result in a more favorable
oxygen supply demand ratio.
The investigators aim to compare the incidence of ECG changes if the mother's blood pressure
is maintained with phenylephrine as compared to ephedrine. To see if these ECG changes are
associated with myocardial ischaemia, the investigators will perform troponin T analysis
after delivery. Troponin T is a molecule released by ischaemic heart muscle.
Study of the Effect of Intramuscular Ephedrine on the Incidence of Nausea and Vomiting During Elective Cesarean Section [Recruiting]
Treatment of Low Metabolic Rate Following Bariatric Surgery [Recruiting]
The purpose of this Research Study is to determine the effect of a combination medication,
ephedrine and caffeine, on metabolic rate and weight loss after gastric bypass surgery.
Approximately 40% of patients struggle with their weight loss rate, or metabolic rate, after
bariatric surgery, and at least 30% previously had or develop a low metabolic rate after
surgery. Metabolic rate is the speed at which calories are burned. The fewer the calories
eaten and the more calories burned, the more rapidly weight is lost. It is possible that
despite a very low calorie intake following bariatric surgery metabolic rate will decrease
so much so that weight does not decrease even if intake is reduced to 1000 calories per day.
Ephedrine is a medicine used commonly to treat asthma, difficulty breathing, and wheezing.
However, 40 years ago it was reported in scientific studies that ephedrine increases weight
loss in patients on low calorie diets. The reason for this is an increase in the amount of
calories that are burned while taking ephedrine. It was also found that combining caffeine
with ephedrine makes ephedrine work more efficiently (more weight loss over time). There
are many studies about the effect of ephedrine on weight loss that began in 1974 with
patients on food diets. Ephedrine used in various strengths and with a number of different
combinations has shown to be effective and safe, especially when directed by a physician.
There is only one study where ephedrine has been used in patients after bariatric surgery.
In that study, both the patient and medical staff knew they were taking ephedrine (i. e.,
they were not "blinded"). The patients who were not losing weight or had measured low
metabolic rates were treated with ephedrine. The patients taking ephedrine lost more weight
after surgery than those not taking ephedrine. While this is a significant finding, the
study was not designed to be the best test of the effects of ephedrine. The best test is
where neither the patients nor the medical staff know if the patient is taking the active
drug (double blind). All patients enrolled into the Research Study will receive capsules
that contain either ephedrine and caffeine (the active drug) or identical capsules with no
active ingredient (called a "placebo"). Neither group of patients will know which set of
capsules they receive. The expected duration of treatment in the Study is 7 months from the
day of surgery. This is a single site study. All patients will have their gastric bypass
performed through Oregon Weight Loss Surgery at Legacy Good Samaritan Hospital. The
investigators expect to study 200 patients with 100 receiving the study drugs (ephedrine and
caffeine in a capsule) and 100 receiving placebo (inactive ingredients in an identical
capsule) over approximately 6 months.